What to Do When Your Partner Is Hot and You're Not

Ask any couple in a long-term relationship about their sex life and you're bound to hear something along the lines of, "It's not as hot as it used to be, but I guess it's still pretty good."

Waning sexual passion over time is the norm for every couple, says Pat Love, Ph.D., the author of "Hot Monogamy" and "The Truth About Love". But the change in desire is usually different for each person.

Desire discrepancy — when one partner has a greater sex drive than the other — is what emerges about 18 months into a relationship, when you're out of the infatuation stage, claims Love. This imbalance is why sex often goes from hot to cold in committed relationships.

Luckily, differences in sexual desire can be resolved and you can reenergize your sexual connection. The key is to appreciate and respond to "your partner's language of love," asserts Love, because "the way to get what you want is to give what your partner desires."

Communicate Your Desire
But first, you have to be able to talk about sex, and that's where couples often hit a brick wall, says Susan Townsend, director of the Relationship Enrichment center in Towson, Md.

Many of us have a hard time communicating about this difficult topic, so we say nothing or we say it in a negative way that closes off communication.

Townsend offers this example: Perhaps what you truly desire is more kissing during foreplay, so you say, "You know, you never really kiss me enough." That is not a desire; it's a criticism. The wording of desire might be, "I've been thinking. Instead of jumping into sex it would be really nice to spend more time kissing first."

The technique is to identify the desire behind every criticism and express it using the language of "rather than" and "instead of," says Townsend, who leads Hot Monogamy sexual workshops. "You wouldn't believe the leap in sexual communication when people start saying, 'Instead of doing…, I'd rather you do…'" she reports.

After you state your sexual desire in a positive way, your partner validates what you've said by repeating it — without editing. You make corrections until he/she gets it right. Then you thank your partner for hearing you and ask if she/he is willing to change to meet your desire. Your partner may reply with a "yes" or "no" or agree if certain conditions are met.

Using this communication technique, also known as "mirroring," may not always result in what you want, but you'll have a much better chance of getting your desires met if you learn to transform your criticisms into requests and pay attention to receiving from, and giving to, your partner.
Furthermore, this style of sharing creates a deeper level of emotional intimacy, which often leads to greater sexual passion.

Make a Contract and Follow Through
It's out in the open. You and your partner have positively communicated specific sexual desires and have made a commitment to respond to one another. Now, it's time to make a contract, suggests Lana Holstein, M.D., a sex expert and author of the book, "How to Have Magnificent Sex: The 7 Dimensions of a Vital Sexual Connection."

Holstein, who also leads sexual workshops at Canyon Ranch in Tucson, Ariz., says that often the problem isn't communicating desire as much as acting on it. The fatigue and grind of daily life bury even the best sexual intentions.

Calling the contract "a deal for sexual wealth," Holstein counsels couples to create a "good sex division" of their relationship. Put down on paper what the two of you want sexually. For instance, you may decide that one of you gets to call the shots for the next month. The partner responsible for initiating sex is also in charge of making the encounter happen.

For the contract to work, you need to be able to begin an encounter from a low level of desire. It's like exercise, explains Holstein. You don't always want to do it, but once you start working out, you're pleased you did. "We don't always feel 'in the mood,' but usually after we're … into it, we're glad to be there and often relieved," she says.

After one month, discuss how the contract is working, which experiences were pleasurable, which taught you something, and which didn't work. Then you can decide to extend or modify the original agreement — and perhaps add penalty clauses for not following through.

Resolving Desire Discrepancy
Once you get the communication and contract going, you are likely to discover that all-too-common problem — desire discrepancy. It occurs in couples of all ages, and contrary to what you might think, it isn't always the man whose sex drive is higher than the woman's. Particularly at midlife, a woman may be coming into her own sexual power just as her man may be feeling less aggressive in sexual relations.

A shift in desire between partners isn't necessarily a problem unless one person feels frustrated or rejected. That's usually the high-desire partner because he or she is doing the initiating yet being sexually scorned.

Learn Your Partner's Language of Love
Pat Love has specific suggestions to help low- and high-desire partners improve their lovemaking. Topping her list is learning your partner's language of love. This gets to the heart of what arouses your partner, and it's often more subtle than sexy underwear for him and chocolate and roses for her.

Love gives this example: Tom would like to make love once a day, whereas Sue is satisfied with once a week. What might soften Sue and make her more responsive to Tom's desire for more frequent sex? Tom needs to become an expert in creating desire in Sue.
What Tom may not be aware of is that there is a connection between Sue's desire and her day-to-day life. She often claims to be too tired for lovemaking because of the kids. But suppose one evening Tom says to Sue, "I'll take the kids for an hour so you can relax and do whatever you want."

This generosity might cause Sue to feel a surge of love for Tom, creating an atmosphere in which sex can ignite. For Sue, Tom's act is foreplay.

"You have to honor the reality and experience of the other," says Love. "You have to jump in there and respond to the cues; you have to find out what says, 'I love you' to your partner."

Practical Tips for the High-Desire Partner
In "Hot Monogamy," Love gives the following suggestions to help restore the balance between high- and low-desire couples. If you're the one with high sexual energy:

* Accept the fact that your partner may need extra stimulation to become fully aroused.
* Refrain from deliberately heightening your level of desire; this will exaggerate differences in desire.
* Honor your partner's sexual preconditions about lovemaking.
* Consider satisfying some of your purely physical needs through masturbation.
* Redirect some of your sexual energy.
* Don't confuse lust with love. Your partner's low sexual desire does not mean a lack of love. If it were, you'd see it played out in all areas of the relationship.

Pointers for the Reduced-Desire Partner

* Take more responsibility for your sexual arousal and make room in your life for sex (write and sign that contract!). Follow through when you do feel in the mood and note the conditions that drive your desire so you can duplicate them.
* Be clear and reasonable about your sexual preconditions and requests.
* If you choose not to have sex, say so without feeling guilt. If you make an effort to compromise with your partner, you don't have to feel guilty when you say no.
* Celebrate your mental desire. Your willingness to get into your partner's frame of mind and create more desire in yourself is a reason to rejoice.

When Is Sex Hot and When Is It Not?

Gina, 34 (single)

* Sizzle… The best sexual experiences for me have always been with men I have established an emotional connection with. After that, spontaneity is a real turn-on — don't pencil me into your Palm Pilot!
* Fizzle… Planned sex is a real turn-off for me. After that, there are a number of things that can point the sex-meter closer to fizzling than sizzling — it could be an argument, physical exhaustion, stress or just one of those days when I'm feeling not-so-sexy.

hot sex
Randy, 46 (single)

* Sizzle… Passion — the burning desire to be with someone. Part of it is feeling really attracted to the person — the physical characteristics — and part is communication.
* Fizzle… Without the physical attraction, the chemistry isn't there. Conflict and resentment are turn-offs, too.

hot sex
Jason, 33 (single)

* Sizzle… The best is what I call "aerobic sex," when you're fully out of breath, completely spent and you know — or at least you believe! — that you're making the other person feel amazing. That's when I can relax and give in to it completely.
* Fizzle… A person who can't kiss past a pucker. And continued bashfulness — I don't care how fit you are, you have to shake what you have and feel sexy, or it's a total turn-off.

hot sex
Gisela, 43 (single)

* Sizzle… A mutual understanding of what a partner wants, both in and out of bed, is so sexy. An honest, sincere, straightforward person who has experience. And I like men and women — I want a man who will be okay with that. You'd think that would be easy to find, but it's not!
* Fizzle… It fizzles if it's just for sex and not for the pleasure of both people. Bragging, like kids, is a total turn-off.

hot sex
Whit, 32 (single)

* Sizzle… Anything unexpected can make sex hot — a break from the norm always makes it memorable. I could write a book — change of location, change of positions, foreplay style, afterplay. A vocal expression is the best — a loud outburst like: "Whit, you da man!"
* Fizzle… That's easy. Lack of communication about the sex that's goin' on makes the top of my list. It's too much guesswork if you don't know what feels good to her because no two women are the same. It's important to cater your style to the woman you're with, and not assume she likes what the last woman did.

hot sex
Rick, 22 (single)

* Sizzle… It's best in the beginning, when everything's new. There's a physical part, and then there's love. The mental aspect — the love — adds to the attraction and makes you feel like you're doing the right thing.
* Fizzle… When you feel you're just a number in someone's life. There's no commitment, and things are getting old. A turn-off is someone being just into themselves and what they want.

hot sex
Donna, 50+ (single)

* Sizzle… The best sex I had was in my 20s. He always knew what I wanted and could wait until we could come together. You attract and sizzle automatically — it must be chemistry, not something learned.
* Fizzle… You definitely have to have an orgasm. Talk about fizzle — it's nothing without that.

hot sex
Bill, 83 (married)

* Sizzle… A very attractive wife like my Win. We have similar interests — we love to dance and travel — and that kind of connection can translate into great lovemaking. We're very close in all respects, physically and emotionally, even more so after 53 years of being together.
* Fizzle… As a result of prostate cancer you can become impotent and can't get an erection. But we've still got it — I'm a lover, a hugger, a kisser — though it's not like before.

hot sex
Dori, 25 (married)

* Sizzle… Self-confidence. Confidence is sexy no matter what. Lack of inhibitions, aggressiveness, taking initiative.
* Fizzle… Roommates. My husband and I have them now — that's why we're buying a house!

hot sex
Sam, 53 (married)

* Sizzle… It takes two to tango. It takes two good companions, with a good relationship outside of the bed. At 53, you might like a 26-year-old hard-body who can do everything, but that's a selfish point of view. It might sizzle for you, but it won't for her.
* Fizzle… If there's poor compatibility mentally, it might be good that one time, but that's it. It's bad if you're doing it for the wrong reason, just to do it instead of to enhance your relationship.

hot sex
Ernest, 63 (married)

* Sizzle… I'm a normal, straight-down-the-line sort of guy. I don't like the unusual stuff, or sex just for convenience. I have to be attracted. My marriage became sexless 20 years ago. My wife accepts that I seek sizzle in extracurricular activities.
* Fizzle… I don't go out with a lady if I'm not attracted. And physically they can be too small sexually. I'm a little bigger than average and sometimes it's just not a fit. I don't like to go right at it; I like to enjoy touching, foreplay — to set things up.

Marriage and Sex

If you're married or thinking about getting married, at some point or another you've wondered what better sex in marriage would be like or how sex in marriage could be improved.

Keeping the sexual spark alive in a marriage or in a long-term relationship is easier said than done. However, couples who take time to cultivate and maintain healthy and satisfying sexual relations tend to be more connected with each other and do not suffer from depression, heart problems and other health maladies, experts say.

The daily routines of life — whether careers, children or financial responsibilities — challenge couples to keep alive that flame that initially brought them together. From a practical standpoint, there's less time for sex and intimacy as relationships develop and individual partners take on more responsibilities.

Furthermore, aging brings on a host of physical conditions that can affect life in the bedroom. These include sexual dysfunction, cardiovascular conditions, arthritis and rheumatism, and a host of other problems.

Whatever the reasons for brewing trouble in the bedroom — whether emotional or physical in nature — the good news is that many such problems are easily treated. Moreover, troubles in a couple's sexual relationship are often signs of other problems, and can serve as a warning sign for still bigger troubles ahead.

"A good sex life is an important part of an individual's overall health," says Mark Schoen, Ph.D., director of sex education for the Sinclair Intimacy Institute. "People who have a good sex life feel better [mentally and physically]."

"Sex can be a wonderful cementer or a terrible wedge" for relationships, says Dr. Linda Banner, Ph.D., a licensed sex therapist specializing in marriage and relationship counseling and a researcher associated with Stanford University Medical School.

Adults Have Sex 61 Times a Year
Adults, on average, have sex about 61 times per year, or slightly more than once a week, according to University of Chicago's National Opinion Research Center. Marital status and age are key influences in sexual activity.

Sexual activity is 25 percent to 300 percent greater for married couples versus the non-married, depending on age. The 1998 University of Chicago report that compiled available sex research also concluded that intercourse is more frequent among couples in happier marriages.


As people age, they tend to have sex less, regardless of whether they are in marriages or not. Married couples between ages 18 and 29 have sexual relations an average of nearly 112 times per year. That rate steadily decreases as people age, so that married couples aged 70 and older have sex 16 times a year on average.

But that fact shouldn't be misconstrued as meaning that older people are less satisfied with their sex life. An AARP survey released last year showed that most mid-life and older adults surveyed were either extremely satisfied or somewhat satisfied with their sex life, and felt it was an important quality-of-life factor.

Renowned sex researcher John McKinley, Ph.D., director of the New England Research Institutes in Watertown, Mass., says as people age, particularly men, their expectations about sex aren't as high.

Overcoming Emotional Barriers
"The worst thing that can happen to a relationship is that a sex life becomes routine and boredom sets in," Schoen says. But in today's fast-paced life, filled with dueling responsibilities, a sub-par or absent sex life is a common problem.

When physical problems are not the root cause of a diminished sex life, many remedies exist to rekindle the flame of passion. Much of the fix is grounded in communication and reprioritizing one's life to make time for love and sex, says Jan Sinatra, a Manchester, Conn., psychotherapist and co-author of "Heart Sense for Women."

Sinatra usually asks couples initially coming to her about their love life how they communicate. "It's a barometer of the relationship."

Sometimes couples need to focus on addressing unresolved conflicts between them, while other spouses just need to remember to have fun when the weight of life's responsibilities drags them and their sex life down. Still others may just need to build time into their schedules to be together and let nature takes its course. Simply setting aside date nights can jump-start one's love life.

Through communication—both verbal and non-verbal — and listening, couples come to understand what ignites that spark in the other partner. That might be cuddling, leaving love notes for your partner to find, meeting at a motel for a tryst, trying out new sex techniques, introducing a vibrator or dozens of other potential turn-ons.



Sex therapist Banner conducted a research study that included 65 couples who were having sexual problems because either one or both partners were diagnosed with sexual dysfunction or arousal problems. The average length of time these couples had been together was 24 years.

The study examined what it would take for these couples to resume normal sexual relations. For 65 percent of the couples, the introduction of educational sex videos was all that was needed to jump-start stagnant sex lives, Banner discovered.
Overcoming Physical Barriers
Sexual dysfunction, however, is not necessarily something that is in one's head, and is a major reason sexual relationships suffer. Erectile dysfunction among men aged 65 and older is usually related to physical problems, says Dr. Michael Werner, a New York urologist, whereas most cases of erectile dysfunction for men under 65 are more psychological.

That's not to say there isn't a mental aspect to erectile dysfunction in older men. As with any medical condition, psychological issues also come into play. For men, much of their self-esteem emanates from how they feel sexually. Erectile dysfunction (ED) affects 25 percent of men either completely or moderately by age 40, McKinlay says. By age 70, that increases to one out of two men.

More important, research in the last three to five years shows that impotence or sexual dysfunction is largely a physical problem, not an emotional problem. "Nearly everything we assumed in the last 95 years was totally wrong," says McKinlay. "E.D. is a circulatory problem, it's part of vascular disease…E.D. is an early warning sign of a heart attack."

In addition to cardiovascular conditions, depression, anxiety and prostate disease can also be factors in sexual dysfunction or sexual problems. And the bad news is that medications for these conditions negatively affect sexual functioning, creating a vicious cycle and making it harder to jump-start one's sex life, and possibly affecting a couple's overall relationship.

Viagra has replaced traditionally invasive treatments for men's sexual dysfunction, and McKinlay says new medications more effective than Viagra will soon hit the market. These will be easier to take, quicker acting and will not pose a cardiovascular threat as Viagra has shown to, he says.

However, what works even better than Viagra for many men with erectile dysfunction, McKinlay says, is increasing one's physical activity, kicking the smoking habit, and watching one's weight and cholesterol. As erectile dysfunction is related to cardiovascular disease, such changes can also reduce the risk of the biggest killer of men in the world.

If that doesn't do it, then McKinlay suggests men work with their doctors to change medications before trying medication specifically for erectile dysfunction. As a last resort, a number of invasive treatments are available.

Meanwhile, older women experience reduced vaginal lubrication and reduced blood flow to sex organs, and the intensity of muscle spasms during an orgasm are diminished. These and other issues can be addressed through estrogen replacement therapy and something as simple as using lubricants.

Although some recommend and swear by such alternative therapies as ginkgo biloba or an amino acid called L-arginine for libido and erection problems, McKinlay says there's no scientific data that shows hormone supplements, herbs or dietary supplements work to address erectile dysfunction. However, that's not to say alternative medicine won't work, he adds.

Strategies for Keeping the Spark Alive

* Treat your partner as if you're dating
* Romance your spouse outside the bedroom
* Plan a date night
* Talk with your partner
* Listen to your partner
* Understand your partner's sexual needs and desires
* Keep physically fit and attractive for your partner
* Maintain perspective on sex as life ebbs and flows
* Resolve any underlying conflicts as they will spillover to the bedroom
* Have fun and engage in foreplay, whether that's kissing, sexual banter or anything else
* Be adventurous and creative in and outside the bedroom
* Exercise, preferably together
* Stop smoking and get your partner to quit
* Watch your weight and cholesterol
* Consider seeking specialized treatment from a specialist if behavioral changes don't work

The Search for a Female Viagra

Two years after Viagra stormed the market and revived erections for millions of men, many women are asking if a women's Viagra exists as a solution to their sex life. Is there a Viagra for women?

The short answer is no — at least not yet. But that could change within the next two or three years as drug companies and researchers race to develop a libido enhancer for a very large — and underserved — market.

Just how large? Some 43 percent of women suffer with sexual dysfunction, compared to 31 percent of men, according to University of Chicago researcher Dr. Edward Laumann. And some $2 to $3 billion will be spent within the next ten years on products aimed at improving the sex lives of these women.

The Drivers of Female Sexual Dysfunction
Female sexual dysfunction is characterized by a lack of desire, arousal and orgasm. Lack of desire is the chief complaint among women, affecting about one-third of them at some point in their lives, says Cindy Meston, assistant professor of clinical psychology at the University of Texas at Austin.

The Cause?
A woman's lack of sexual interest is often tied to her relationship with her partner, says Sandra Lieblum, director for sexual and marital health at the UMDNJ Robert Wood Johnson Medical School in Piscataway, N.J. "The important sex organ [for women] is between the ears. Men need a place for having sex — women need a purpose," she says. But it can also be triggered by family concerns, illness or death, financial or job worries, childcare responsibilities, managing a career and children, previous or current physical and emotional abuse, fatigue and depression.

Indeed, female sexual dysfunction seems to be psychologically — rather than physically — rooted. "What the genitals are doing may play a less important role in how a woman defines her sexual arousal," says Meston. "I don't think there will ever be an aphrodisiac that will make [women] want to have sex all the time."

That's not to say its causes aren't physical, Lieblum says. Hypertension, heart disease, cancer, diabetes, thyroid disorders, neurological diseases and autoimmune disorders like lupus can all contribute to a woman's lack of sexual desire. Other factors include prescriptions drugs, particularly anti-hypertensives and depression medication, as well as over-the-counter medications and illegal drugs and alcohol abuse.

Why Not Viagra?
Viagra is designed to increase blood flow to the genitals. Viagra works well for many men who suffer with impotence — or erectile dysfunction — because it's considered a physical — rather than an emotional — problem. That's not to say that Viagra can't "restore function" for women, says Dr. Myron Murdoch, clinical instructor of urology at George Washington Medical School. It can, but it's not for all women.

While Viagra-like drugs may help the 20 percent of women reported to have difficulties with lubrication (blood flow to the female genitals increase lubrication), it's unknown to what degree such drugs would help the 43 percent of women with sexual dysfunction who either say they're uninterested in sex or that sex provides little pleasure.
Cure in a Pill?
Even so, drug companies — banking on the success of Viagra — hope to find its female equivalent. At the moment, they are focused on developing a drug that increases blood flow to the female genitals, resulting in vaginal lubrication and relaxing vaginal muscles.

The concept is similar to Viagra, which increases blood flow to the penis, resulting in an erection. So far, there are some promising drugs on the horizon. These include prostaglandin, already approved for men, apomorphine and phentolamine, both of which are being tested for arousal disorder in women.

Whether drug companies succeed, the good news is that women needn't wait for a sex pill. They have options. Research shows that exercise, counseling, vaginal lubrication products and sex videos all can help put spur a woman's libido.

What's more, the three following options — while scientifically unproven — are readily available and also hold the promise for improving a woman's sex life.

* L-arginine amino acid cream
The same amino acid that has been used by athletes to promote muscle development is purported to increase blood flow to the female genitals, thus sparking sexual urges. "Our informal studies on 500 patients showed that 70 percent of women who applied this cream to the clitoris and labia a half hour before sex reported more arousal and stronger orgasms," says Dr. Jed Kaminetsky, clinical assistant professor of urology at the New York School of Medicine.
* DHEA
Dehydroepiandrosterone is a male hormone produced by the adrenal gland and ovaries and converted to testosterone and estrogen. DHEA, which depletes with age, can be purchased over the counter in supplement form.In one small study published in the New England Journal of Medicine (Sept. 30, 1999), women who took 50 mg of DHEA daily noticed a significant increase in sexual interest. Other preliminary findings report encouraging results. However, most DHEA products lining the store shelves recommend taking only 25 mg per day. Because of its potential for heart attacks and breast cancer and masculating side-effects such as facial hair, DHEA is best used under a doctor's supervision.
* Testosterone therapy
For women who have undergone oophorectomy (the removal of one or both ovaries) and hysterectomy, testosterone treatment has shown to improve sexual function and psychological well being, according to recent research from Boston's Massachusetts General Hospital.

However, women looking to boost testosterone levels should work with their physician closely so the hormone can be monitored. Too much of it can cause, among other things, facial hair and change a women's voice, which is irreversible. Meanwhile, a study looking at the combination of L-arginine glutamate and yohimbine — a natural extract from tree bark that excites part of the central nervous system — has shown that postmenopausal women were more than twice as aroused after taking the combination drug and viewing an erotic film than women who took a placebo.

Exercises to Improve Your Sex Life

Sex. It can ignite our senses, fill us with ripples of pleasure and awaken a new dimension of feeling for our partner. Lovemaking doesn't require extraordinary skill, nor is it limited to young couples in the throes of passion. Couples of all ages can cultivate sexual bliss for the duration of their lives together.

So what's the trick? One of the most important and often overlooked components of a rewarding sex life is exercise. Regular exercise can pique sexual desire and make sex more enjoyable.

Good Sex Is a Good Thing
Though definitions vary, "good sex" might be thought of as an act of intimacy that promotes health and well-being. Good sex provides significant physical and physiological benefits. Enjoyed in the context of a happy relationship, "sex boosts chemicals in the body that protect against disease," says Paul Pearsall, Ph.D., author of the book "Superimmunity."

Research also suggests that sex and masturbation can help ease joint and muscle pain, combat depression, promote heart health and lengthen life span.

All too often, however, we haven't the time or energy for sex. According to the Masters and Johnson Institute, at least a third of American couples experience a lack of sexual desire. After a stressful day at work, it's easy to neglect the ultimate celebration of human pleasure.

There are ways to ensure that lovemaking remains a passionate, intense and regular part of our repertoire no matter what our age or how busy our lifestyle.



Create Energy for Sex — Get Moving
The surest way to whet sexual appetite and increase sexual activity is through physical exercise. Potent medicine, aerobic exercise revs up hormones, flushes stress, whittles away fat and rejuvenates the body, filling us with renewed vigor, greater confidence and the glow of good health. Regular exercise also increases blood flow to the genitals, priming men and women for sex.

"Beginning a fitness routine has made a difference in our sex life," remarks 42-year-old Mary Jane Platt, a mother of three. "Since we began biking together, we have so much more energy for each other. It's wonderful."

Mary Jane's experience isn't unusual. A University of California study of middle-aged, sedentary men found that after just one hour of exercise three times a week, the men demonstrated improved sexual function, more frequent sex and orgasms and greater satisfaction.

Similarly, researchers at Bentley College in Massachusetts found that women in their 40s engaged in sex more often (about seven times per month), and enjoyed it more than a sedentary group of peers. Since sex can be an act of endurance, improving cardiovascular fitness with aerobic activity such as walking, running, cycling or swimming for at least 30 minutes, three times per week, will help both partners perform longer and more often.

Push-ups and sit-ups or crunches are also beneficial exercises to add to an aerobic routine. They strengthen the shoulders, chest and abdominals, all of which are utilized during sexual intercourse. Keeping these muscles strong helps increase strength and stamina, adding to prolonged, more pleasurable sex.

"Warm Ups" for Sex — Practice the Squeeze
Unlike the muscles in our arms or legs, sex muscles are rarely active during the course of the day. However, by strengthening these "secret" muscles, couples can enjoy more intense sex. Kegel exercises firm the muscles of the vagina, helping women gain muscle control (to grip the penis) and reach orgasm more easily.



Men can use this exercise to delay ejaculation by contracting the pubococcygeal (PC) muscles just before orgasm, then fully relaxing them. Named after Los Angeles physician Arnold Kegel, these exercises strengthen the PC muscles in the pelvis. Though sometimes confused with the abdominal muscles, PCs are the muscles used to stop the flow of urine midstream (not the muscles used to hold in your stomach or tighten your buttocks).

Here's how Kegels work: Contract your PC muscles by clenching, as though stopping urine, and hold for at least two to three seconds per squeeze. Inhale as you squeeze each time and try to fully relax your muscles between each contraction. So you don't get sore, start with just 10 or 20 squeezes. Kegels can be practiced nearly anytime and in any place.

Try them in the morning with each bite of breakfast, while chatting with a co-worker, while watching television or flipping the pages of a magazine until you can do at least 100 to 200 each day. "The squeeze" is fun and easy, and can stimulate erotic feelings. Daily workouts for about one month should yield results.

S-t-r-e-t-c-h-e-s
The following pelvic stretches will help keep the muscles used during sex limber and flexible and help facilitate orgasm. Each stretch can be done in the bedroom on a firm mattress or on the floor. Wear either loose clothing or nothing at all, and consider playing your favorite music. As these exercises can arouse strong sexual desire, you may wish to try these with your partner.
Pelvic Lifts
Lie on your back with knees bent and slightly apart. Feet should be flat on the floor and arms at your side. Inhale, clenching your abdominals and buttocks and lifting the pelvis until your back is straight. Take care not to arch your back. Breathe as you hold the position for at least 10 seconds. Exhale as you lower your body and repeat the exercise.

After you complete your lifts, try a few pelvic bounces, an exercise that can "evoke powerful sexual feelings," according to sex therapists David and Ellen Ramsdale.


As with the pelvic lift, knees are bent and slightly apart. Your palms should face up. Inhale and lift your pelvis just slightly off the ground. Then, exhale and let it down so your lower back bounces gently against the floor. Experiment with variations. Your goal is to feel a sense of openness and release.

The Butterfly
Lie on your back with knees bent. Feet should be together and flat on the bed. Next, pull your feet in until they touch your buttocks. Turn your ankles so the soles of your feet are facing each other and touching. Your knees will point out to the sides of the bed.

Lower your knees toward the bed taking care not to force them down. You or your partner may gently press downward on your inner thighs. When your knees are as far apart as is comfortable, hold for 60 seconds. Gently bring the knees back together with your hands and relax.

This exercise can also be done sitting up, back-to-back with your partner. Sit up as straight as possible with your spines pressed gently together. Relax your shoulders and keep your head in line with your spine. Bring your feet in as close to your body as possible, and turn them so your soles touch and knees point out. Clasp your feet. Breathe deeply and watch as your knees begin to lower, taking care not to force the knees down.

The butterfly is also beneficial for menstrual irregularities urinary problems and is thought to help ease the pain of childbirth.

Sexual Fitness
There are many other exercises and stretches that can enhance not only our sex lives but our mental and physical health. Yoga and dance classes offer great workouts and help stretch the pelvic region. Swimming and other sports that involve kicking motion, are also beneficial.

Regular exercise of almost any kind helps elevate energy, stamina, passion, pleasure…all aspects of our sex lives. So exercise and enjoy! The benefits are many.

Estrogen and Testosterone Hormones

The differences between female hormones and male hormones may not be as specific as you might think. The definition of a hormone is a chemical substance produced by an endocrine gland that has a specific effect on the activities of other organs in the body. The major female and male hormones can be classified as estrogens or androgens. Both classes of male and female hormones are present in both males and females alike, but in vastly different amounts. Most men produce 6-8 mg of the male hormone testosterone (an androgen) per day, compared to most women who produce 0.5 mg daily. Female hormones, estrogens, are also present in both sexes, but in larger amounts for women.

Estrogens are the sex hormones produced primarily by a female's ovaries that stimulate the growth of a girl's sex organs, as well as her breasts and pubic hair, known as secondary sex characteristics. Estrogens also regulate the functioning of the menstrual cycle.

In the majority of women, ovarian hormones appear not to play a significant role in their sex drive. In one study of women under the age of 40, 90 percent reported experiencing no change in sexual desire or functioning after sex hormone production was shut down because of the removal of both ovaries.

The Importance of Estrogen
Estrogens are important in maintaining the condition of the vaginal lining and its elasticity, and in producing vaginal lubrication. They also help preserve the texture and function of a woman's breasts.

In men, estrogens have no known function. An unusually high level, however, may reduce sexual appetite, cause erectile difficulties, produce some breast enlargement, and result in the loss of body hair in some men.

Androgens are sex hormones produced primarily by a male's testes, but are also produced in small amounts by the female's ovaries and the adrenal gland, an organ found in both sexes. Androgens help trigger the development of the testes and penis in the male fetus. They jump start the process of puberty and influence the development of facial, body and pubic hair, deepening of the voice, and muscle development, the male secondary sex characteristics.

After puberty, androgens, specifically testosterone, play a role in the regulation of the sex drive. Large deficiencies of testosterone may cause a drop in sexual desire, and excessive testosterone may heighten sexual interest in both sexes. However, testosterone levels are poorly correlated with sexual interest and drive when they are within the average range. Sex drive is much more likely to be affected by external stimuli (sights, sound, touch) than by variations in sex hormones, except in extreme cases.

Too Little Testosterone in Men
In men, too little testosterone may cause difficulty obtaining or maintaining erections, but it is not clear whether testosterone deficiencies interfere with female sexual functioning apart from reducing desire.

However, there is no evidence whatsoever to suggest that because women have less testosterone than men do, they have lower sexual interest than their male counterparts. Instead, it seems that women detect and react to much smaller amounts of testosterone in their circulation than men do.
Aging, illness and certain cancer treatments can affect our bodies' delicate hormonal balance, causing changes in sexual interest and functioning. Familiar to most are the changes that occur when a woman goes through menopause. Estrogen production drops throughout this process as a woman exits her child-bearing years.

The major sexual impact of decreased estrogen is a shrinking of the vagina and thinning of the vaginal walls, along with a loss of elasticity and decreased vaginal lubrication during sexual arousal. Some women experience only slight changes in sexual functioning, while others have dryness and pain with intercourse, or genital soreness for a few days after sexual activity, if they don't use a vaginal lubricant or take some form of hormone replacement.

Researchers investigating the effects of hormone replacement therapy on women's sexual functioning have shown that taking estrogen often allows sexual functioning to return to normal. In addition, androgens have been prescribed for postmenopausal women to enhance their sexual desire.

Hormone-Replacement Therapy
Perhaps less well known is the fact that men sometimes experience lowered testosterone levels, which can be responsible for sexual dysfunction. How this hormonal decrease affects the man's sex drive and erections remains unclear. But urologists, as a treatment for these difficulties, sometimes recommend testosterone replacement. There is a great deal yet to be learned about which men and women may require and benefit from hormone-replacement therapy.

It is tempting to try to understand sexual behavior solely in terms of hormones. In many animal species hormones that control the female's willingness to mate and the courtship and sexual behavior of the male tightly regulate patterns of sexual behavior.

In humans, however, there is a more complicated relationship between hormones and sexual behavior. Although a substantial testosterone deficiency usually reduces sexual interest in men and women, there are cases in which that effect is not seen.

Similarly, although many men with below normal testosterone levels have difficulty with erections, not all do. Women who have low amounts of estrogen in their bodies do not lose their ability to be sexually aroused or to have orgasms.

In short, sex hormones are not the only factors affecting sexual interest or behavior. If you are concerned about your hormone levels and whether they may be effecting your general health or your sexual functioning, consult your doctor for some easily performed and (almost) painless laboratory blood work.

Erotic Recipes

These aphrodisiac dishes are nutritious, low-fat and easy to prepare.

Oyster Stew

* 1 pint shucked oysters
* 1 cup finely chopped onion or sliced leek
* 2 tsp butter
* 1/2 tsp salt
* 2 cup skim milk
* 1 cup half and half
* 1 T fresh parsley
* 1/4 tsp white pepper

In a large saucepan, cook onion or leek in butter until tender. Stir in oysters and salt. Cook over medium heat for 5 minutes, until oysters curl around the edges. Stir in milk, cream, parsley and pepper. Heat through. Serves 4 to 6.

Acorn Squash with Apricot Glaze

* 2 medium acorn squash
* 1 medium apple, sliced
* 2 medium apricots, sliced. Or, 1 peach, peeled and sliced
* 1/4 cup apricot nectar
* 2 T honey
* 1/4 tsp ground nutmeg
* 1 T butter

Halve squash and discard seeds. Place squash in a baking dish with about one-quarter inch of water. Bake at 350 degrees until tender (usually 30 to 45 minutes). Or, microwave for 12 minutes until tender. In a small bowl, combine apple, apricots, nectar, honey and nutmeg. Turn squash over and spoon mixture into the cavities. Cook until hot. Garnish with nutmeg. Serves 4.

Asparagus Bouquet

* 1 to 1 and 1/2 lbs fresh asparagus
* 2 tsp olive oil or butter
* 2 T snipped fresh chervil or 2 tsp tarragon
* A dash of course salt

Preheat oven to 475 degrees. Cut woody bases from asparagus. Combine oil and 1 T chervil or 1 tsp tarragon. Drizzle over asparagus. Toss to coat. Roast 4 to 6 minutes in greased baking pan until tender. To serve, place upright in a jar. Sprinkle with remaining chervil. Makes 6 servings.

Erotic Power of Food - Must read

The erotic power of food has been celebrated for centuries. Casanova was said to share oysters with his paramours to whet their sexual appetites. Greek and Roman cultures enjoyed a parade of ripe fruits and exotic dishes before engaging in sensual pleasures. It has even been said that a delicious meal is the quickest way to a man (or woman's) heart. Afterall, what courtship would be complete without a romantic dinner?

Nutrition plays a vital role in love and lovemaking. The quality of our diet has a great deal to do with the quality of our sex. Many nutritious foods can stir libido, revive sexual function and enhance overall health, especially when served up in a sensual way.

Healthy Ingredients for "Gourmet Love"
The dietary ingredients for a lifetime of wonderful sex include a variety of fresh, wholesome fruits and vegetables, and lean proteins. Complex carbohydrates should be the centerpiece of a healthy sex diet, with lean proteins comprising about 20% to 30% of daily calories, advises Chris Meletis, N.D., chief medical officer at the National College of Naturopathic Medicine. Meals rich in fruits and vegetables provide beneficial nutrients that keep organs in peak condition and energy at maximum levels, both of which are essential for lovemaking.

Although some foods arouse, others can impair sexual function. Fried fare and rich cream sauces can leave us feeling more sluggish than sexy. What's more, excessive sugar, salt, saturated fat and highly processed foods are linked to frigidity, difficulty reaching orgasm and lack of interest in sex. Cutting back on these foods will help revive and preserve sexual vitality and enhance overall well-being. It's also a good idea to limit consumption of alcohol and coffee, and to skip tobacco altogether. These "pleasure drugs" can dampen sexual desire and leech beneficial nutrients vital to our sexual health.

The good news is that some indulgences are beneficial. The rich, delicious decadence known as chocolate contains phenylalanine, an amino acid that raises the body's endorphins, our natural antidepressants. Enjoyed in moderation, a few morsels can lift libido, providing a tantalizing prelude to sex.

The following is a selection of high vitality, fresh foods that supply nutrients essential for a healthy sex life. "Looked at in the right light," writes author Diane Ackerman in "A Natural History of the Senses," "any food might be thought aphrodisiac."

Taking the time to investigate which fruits and vegetables appeal most in terms of their fragrance, shape, touch, texture (and of course, taste), allows us to see our sustenance with new eyes. With these characteristics in mind, gathering the ingredients for a "sensual" new way of eating can be fun.

Here are some tips:

* Feast on fruits. Bursting with fiber and antioxidants, and thought to be imbued with aphrodisiac properties, many fresh fruits are as sensual as they are nutritious. Apples, apricots, bananas, cherries, coconut, dates, figs, grapes, mangoes, papayas, peaches, pears, plums, pomegranates, quince, raspberries and strawberries are celebrated in erotic literature throughout the world. Whichever fruits you choose, enjoy them often, and with a new appreciation of their attributes.
* Devour delicious vegetables. Asparagus, carrots, celery, corn, cucumbers, carrots, eggplant and several other phallic-shaped vegetables have long been prized for their aphrodisiac effects. Although it may be hard to think of them as "erotic", these earthly delights certainly invigorate the body with vitamins and minerals. The avocado, on the other hand, is undeniably sensual—so much so that the Spanish conquistadors helped spread its reputation throughout the world as a powerful stimulant.

The juicy tomato, or "love apple," a potent source of the powerhouse antioxidant, lycopene, was once a highly sought-after libido enhancer. Other veggies reputed to turn up the heat and fortify the body, include: beans, garlic, leeks, onions, parsley, peppers, soybeans, spinach, truffles, turnips and watercress. Serve these foods often for optimal sexual health.
* Savor fruits of the sea and lean proteins. Shellfish including abalone, oysters, clams, scallops, shrimp, lobster and deep, cold-water fish like cod and halibut, fuel the body, brain the and sex drive. Oysters, for instance, are rich in zinc and iodine. Zinc, a vital sexual nutriment, is essential for testosterone production in men and women.
* Eat lean meats. Meats such as chicken and turkey are healthful in moderation. "Good protein intake is important, but excessive amounts can interfere with sexuality," warns Elson Haas, M.D., and author of "Staying Healthy With Nutrition". If possible, choose organic meats to avoid hormones, antibiotics and other additives typically found in these foods. Nuts, seeds and beans are also excellent sources of protein. Both pine nuts and pumpkin seeds are sexual adjuvants.
* Get a little on the side. Although a healthy diet provides most of the nourishment necessary for sexual wellness, a multivitamin/mineral supplement offers extra health insurance. Vitamins including A, the B group, C and E are necessary for sexual functioning. Vitamin E, for instance, supplies the sex organs with sufficient oxygen. B vitamins, including niacin and B-5, can help men and women reach orgasm and improve sexual stamina. Selenium, manganese and of course, zinc, are also vital in regulating hormones and revving up sex drive. Rather than taking these individually, take a multivitamin/mineral to ensure correct dosages. Check with your doctor to learn which brands he or she recommends.

The Erotic Element
Now that the ingredients are in place, it's time to have some fun!

Start by taking the time to savor each meal. Nutritious foods fuel our sexual energy, but it is the art of eating that can be truly erotic.

A lovingly prepared meal served in the proper ambience can precipitate passion. To help set the mood for a night of romance, try some of the following:

* Prepare a dinner for two with your beloved. (How about cooking in the nude for some added spice?)
* Spread a blanket on the floor set with candles and flowers, but no silverware.
* Dim the lights and play music that sets the right mood.
* Sip champagne, wine (one glass can be a turn on) or seltzer water.
* Serve fingerfoods such as olives or raw vegetables and dip.
* Feed your partner a juicy slice of mango, a delicate sliver of pear, or sweet grapes.
* Take turns feeding each other in creative ways.(Offer to nibble ripe raspberries from your lover's chest.)
* Finish with an arousing massage or a warm bubble bath.

For a real adventure, try a picnic in a secluded park, on the beach, or even in the bedroom. Pack light foods that can be fed to each other such as strawberries and chocolate, hard-boiled eggs, yogurt, French bread and low-fat cheese. Wear something sexy. And don't forget a blanket. Treat each course as an overture to lovemaking.

Birth control

Birth control and contraception refer to the conscious regulation of the conception and birth of children, also known as family planning.

Generally, birth control and the use of contraceptive methods are employed to limit the number of children that are born or to spread out their time of birth.

Sometimes birth control is practiced for a specific period of time (several months or years), and sometimes — when there is a medical or other reason to end conception — it is practiced until the end of fertility. Birth control strategies of various kinds and with varying degrees of effectiveness are used around the world.

Without use of any birth control method, for every 100 fertile women 60-80 will become pregnant during the course of a year in which intercourse occurs regularly.

For girls age 15-19, this figure is about 90 percent. The modern birth control movement began in England, after the writings of Malthus on the potential for population growth sparked concern about world overpopulation.

The first clinic devoted to birth-control in the U.S. was launched by Margaret Sanger in 1916. Sanger, a nurse, organized the first national and international conferences on birth control and organized a committee to lobby for birth control laws.

The Catholic Church has been a major opponent of the birth control movement. While the Catholic Church accepts abstinence from intercourse and use of the so-called rhythm method (limiting intercourse to the least fertile periods in a woman's monthly cycle) as acceptable birth control activities, it strongly and vocally opposes other methods.

For individuals who choose to use birth control, various approaches are available. Considerations in selection include safety (e.g., protection from sexually transmitted diseases and HIV, as well as avoiding side effects of birth control use), effectiveness, convenience, cost, personal acceptance, and partner attitudes.

The Pill as Birth Control and Contraceptive
All methods of birth control have their advantages and disadvantages. The oral contraceptive pill (often called "the pill") has become a widely used medically prescribed birth control method in many parts of the world.

The pill consists of two synthetic hormones that are equivalent to estrogen and progestin, pituitary hormones that regulate a woman's menstrual cycle.

Most forms of the pill block a woman's ovaries from releasing eggs. Used appropriately and consistently for 21 days during the monthly cycle, the pill has been found to be 97-99% effective in preventing pregnancy. This high level of success, as well as the fact that the pill is easy to use and does not disrupt intercourse, has made it particularly appealing.

For younger women, the pill also may reduce the risk of various diseases including cancer of the ovaries and endometrium, benign breast cysts, premenstrual syndrome, and iron-deficiency anemia. However, the pill confers no protection from sexually transmitted diseases (STDs) or HIV; also, its use may promote nausea, weight gain, and increased blood-clotting. Taking the pill also has been found to be associated with heightened risk for cervical cancer. Women who take the pill are expected to have regular gynecological exams and to report any symptoms (e.g., unexplained vaginal bleeding, abdominal pain, dizziness, depression) to their primary care provider. Certain women (e.g., those over the age of 35, heavy smokers, those with various heart or vascular problems, those with a history of cancer) are discouraged from taking the pill.

The Diaphragm as Birth Control and Contraceptive
The diaphragm is a bowl-shaped flexible cup that is inserted into the vagina so that it covers the cervix. Commonly used with a spermicidal cream or jelly that kills sperm, the diaphragm stops sperm from entering the uterus.

Spermicidal use is important with diaphragms because they are not completely effective in stopping sperm. When used carefully, diaphragms have been found to be 82-95 percent effective in preventing pregnancy and they may provide some protection from STDs.

Diaphragms must be fitted by a physician to insure that the right size is being used. They can be inserted into the vagina up to six hours prior to intercourse and may be left in place for 24 hours after intercourse (and must be left in place for at least six hours to insure effectiveness).

If intercourse is repeated during this period, additional spermicide can be inserted without removing the diaphragm. Annual gynecological check ups and diaphragm checks are recommended, especially if the woman's weight changes or she recently has had a pregnancy. Potential side effects include irritation, bladder infection, and unusual vaginal discharge.

The most significant potential health risk of using the diaphragm is toxic shock syndrome. Symptoms, which should be reported to one's primary care provider immediately, include vomiting, high fever, diarrhea, a sunburn-like rash, and general itching in the genital area.


The Condom as Birth Control and Contraceptive
The condom is the most widely used male contraceptive. It is made from thin rubber, polyurethane, or animal tissue and covers the penis, blocking sperm from entering the vagina.

Condoms are now widely and easily available in most parts of the U.S., in pharmacies and AIDS prevention projects, and are available in varying colors, with and without lubricants, and with and without spermicide. Sometimes they are used with foam or vaginal inserts which contain a chemical that stops sperm from swimming.

Used correctly, condoms by themselves are 88-92 percent effective in preventing pregnancy. Foam used alone is 72-97 percent effective in pregnancy prevention. When used together, condoms and foam or vaginal inserts are 98-99 percent effective. Latex and polyurethane (but not "natural" animal skin) condoms are also effective in preventing the transmission of STDs and HIV.

Moreover, these methods are relatively inexpensive, are available without a prescription or doctor's exam, and have few if any side effects (although some people have allergies to spermicide or latex). Condom failure is often the consequence of improper use, especially failing to leave a small space at the head of the condom to catch the ejaculated semen, or having the condom come off while the penis is still in the vagina.

Care must be taken as well to use a finger to hold the condom in place when removing the penis from the vagina to avoid spillage. On the negative side, condoms must be replaced before each time intercourse occurs and many men complain that condoms dull physical pleasure.

Female Condom as Birth Control and Contraceptive
Recently, a female condom has come on the market, although it is still comparatively expensive. The female condom consists of a loose-fitting, lubricated polyurethane sheath (that is inserted into the vagina) and two flexible polyurethane rings. One ring is fixed at the closed, narrow end of the sheath and serves as an insertion device, the other ring forms the opposite external edge of the sheath and remains outside of the vagina covering the external labia. Because the female condom is relatively new, many women have not had experience with it and its popularity is not yet determined.

The Cervical Cap as Birth Control and Contraceptive
A range of additional contraceptives are readily available, including the cervical cap, a thimble shaped rubber or plastic cap that fits securely over the cervix and extends into the vagina. Used with a spermicide, the effectiveness of the cap is comparable to that of a diaphragm. Like the diaphragm, it can be inserted long before intercourse (but can be left in for up to 3 days after intercourse) and is found to be more comfortable than a diaphragm by some women.

Synthetic Hormones as Birth Control and Contraceptive
Depo Provera is a long-lasting birth control method that involves injection of a synthetic hormone called progestin every three months. The drug has been found to be almost 100 percent effective in preventing pregnancy, but is associated with a long list of possible side effects including headaches, weight gain, irregular bleeding, depression, nervousness, dark spotting of the skin, change in hair growth, and change in sex drive.

The IUD as Birth Control and Contraceptive
The Intra-Uterine Device (IUD) is a plastic object, often t-shaped, that is medically inserted into a woman's uterus. The IUD contains copper or a hormone that prevents sperm from joining with the egg. Found to be 97-99 percent effective in preventing pregnancy, IUDs may cause tubal pregnancy, menstrual cramping, and infection.

Norplant as Birth Control and Contraceptive
Norplant is a long-term birth control method that involves the medical insertion of six soft capsules (about the size of a match stick) under the skin of the upper arm. The implant releases the synthetic hormone progestin into the body over a five-year period preventing the ovaries from releasing eggs. This method is over 99 percent effective but is associated with a range of side effects including irregular menstruation, weight gain, change in appetite, acne, headaches, gain or loss of facial hair, depression, nervousness, and ovarian cysts.

Finally, there are surgical procedures: vasectomy (to block the vas deferens tubes that carry sperm) in men and tubal ligation (blocking the fallopian tubes that transport eggs) in women. These are extremely effective birth control methods.

Like all surgery, there are some risks, but they are rare in both procedures. Tubal ligation is relatively expensive (over $1000); vasectomy is somewhat less expensive. Both of these procedures are surgically reversible (an expensive procedure) with relatively high success rates. Neither of these methods, however, prevents the spread of STDs or HIV.

Given the wide range of birth control methods, with varying costs and benefits, careful consideration and discussion with partners and health care providers is needed to make an appropriate decision.

Bartholin's Glands

Bartholin's Glands are part of a woman's internal genitals. They are located on each side of the labia minora (inner lips of the vaginal opening; see vulva), and they secrete small amounts (a drop or two) of fluid when a woman is sexually aroused.

The small drops of fluid were once thought to be important for lubricating the vagina, but the research of Masters and Johnson demonstrated that vaginal lubrication comes from further within the vagina. The fluid may slightly moisten the opening of the vagina (labia), making contact on this sensitive area more comfortable.

The Bartholin's glands can become irritated or infected, resulting in swelling and pain. This unusual condition can be easily treated by a qualified medical professional.

Contributions to American Sexuality

Kinsey is regarded by many to be the foremost pioneer in the quantitative study of human sexuality. From his roots studying marriage and sex to his quantitative studies on women's sexuality, Dr. Alfred Kinsey is a research pioneer in human sexuality.

His interest in human sexuality fortuitously began when in 1938 the Indiana Association of Women Students petitioned the university to offer a noncredit course on marriage. Kinsey coordinated the course and presented lectures on the biological dimensions of sex and marriage. In preparing for his lectures in what quickly became a very popular course, he discovered that little survey research was available on human sexuality.

Initially, Kinsey gathered data from students in his classes, then from other students and faculty, and later from people whom he could persuade to be interviewed. At his own expense, he interviewed people in other Midwestern cities, thereby adding people from other social classes to his sample.

In 1941, Kinsey obtained a grant from the National Council's Committee for Research in the Problems of Sex, which was at the time funded by the Rockefeller Foundation. He assembled a multidisciplinary research team that included Clyde Martin, a student assistant who became a research associate; Wardwell Pomeroy, a clinical psychologist; and Paul Gebhard, an anthropologist. Kinsey and his colleagues established the Institute for Sex Research in 1947 as a separate, nonprofit organization.

Kinsey — A Controversial Seller
Kinsey published "Sexual Behavior In The Human Male" in 1948, which came to be known as the "Kinsey Report." The report immediately created controversy for its revelations of the sexuality of white American males. It sold more than 250,000 copies and was translated into a dozen languages.

In 1953 the Institute published Sexual Behavior In The Human Female, which also sold more than 250,000 copies and was translated into several languages. These two reports sharply challenged many myths about sexual behavior in American society and revealed findings on various previously taboo topics, such as extramarital sexuality, homosexuality, bisexuality, oral sex, masturbation, and prostitution.

Kinsey's research focused on six different outlets to sexual orgasm, namely masturbation, petting, nocturnal dreams, heterosexual coitus, homosexual behaviors, and bestiality. He related these forms of sexuality to various socioeconomic variables, namely age, education, marital status, occupation, and religious identification.

Many Americans in particular were shocked to learn that females are as capable of sexual response as men. Previously, the prevailing cultural myth was that women merely engaged in sex for procreative purposes or to please their male partners. Half of the females interviewed stated that they had engaged in premarital coitus and one-quarter stated that they had engaged in extramarital sex.

Kinsey's Homosexuality Statistics Shocked America
Kinsey's findings on homosexuality also shocked the American public. He reported that a third of American males and 13 percent of American females claimed to have had at least one same-sex orgasmic experience by age 45.

Furthermore, approximately 10 percent of the males admitted to having been predominantly homosexual for at least three years between the ages of 16 and 55, and four percent of white males described themselves as exclusively homosexual. Kinsey's research refuted the widely held notion that heterosexuality and homosexuality are exclusive forms of behavior.

Additionally, Kinsey found that a person's sexual orientation could change over the course of his or her lifetime. The two Kinsey reports also revealed a widespread prevalence of masturbation. His study found that more than 90 percent of white males and 62 percent of females admitted having engaged in this behavior.

Kinsey Contributes to the Sexual Revolution
A major weakness of the two Kinsey reports was their failure to examine the sexual behavior of people of color in the United States. Furthermore, the samples relied heavily upon middle-class, college-educated Americans under age 35.

Despite these limitations, the Kinsey reports served as significant benchmarks in the quantitative study of sexuality in U.S. society and their findings contributed to an era of more relaxed attitudes concerning sexual behavior. In this sense, the Kinsey reports contributed to what has been termed the Sexual Revolution, or reconfiguration of sexual mores after the Second World War. Kinsey's research and other studies by the Institute for Sex Research created and continue to create controversy in the larger society, particularly among conservative social forces. A Congressional committee accused the Institute of contributing to an alleged Communist takeover of the United States and accused the Rockefeller Foundation of "un-American" behavior, resulting in the latter's decision to withdraw funding for the Institute.

Attacks upon Kinsey's research appear to have contributed to his untimely death at age 62 in 1956. Nevertheless, the Institute has continued to produce a long list of studies of American sexual behavior including: "Pregnancy, Birth, and Abortion" (1958); "Sexual Offenders: An Analysis of Types" (1965); "Homosexualities: A Study of Diversity Among Men and Women" (1978); and "Sexuality and Morality in the U.S." (1989). Despite the wide-spread acceptance of the scientific study of sexuality in U.S. society, conservative forces continue to attack the work pioneered by Kinsey as well as on-going studies by the Institute for Sexual Research.

HUMAN SEXUAL DIFFERENTIATION

Fetal sexual differentiation is a very complicated series of events actively programmed, at appropriate critical periods of fetal life, which involves both genetic and hormonal factors leading to the sexual dimorphism observed at birth (Table 1). Sexual differentiation is achieved at midgestation. Genetic factors and hormonal factors will alternate in this chain of programmed transformations of the primary gonads, the internal sex structures and the external genitalia. Sex chromosomes promote the development and the differentiation of the primary gonad but the decisive influences are the presence or absence of testosterone and of antimüllerian hormone production by the testis. Femaleness results from the absence of any masculinizing genetic factor or hormone acting during the critical period of differentiation. Brain and hypothalamic sexual identities are mainly acquired during postnatal life. Gender and behaviour identities are markedly influenced by psychosocial imprinting.

Sexual differentiation is conformed in the human during four successive steps: the constitution of the genetic sex, the differentiation of the gonads, the differentiation of the internal and the external genital tractus and the differentiation of the brain and the hypothalamus.

Genetic sex

The critical role of the Y chromosome and of male hormones in male orientation is well documented, the development of the female sexual differentiation occurring in the absence of male genetic determinants.

Genetic sex is established at the time of fecundation by the nature of the chromosomal composition of the spermatozoon, whether it contains a Y chromosome which has a dominant effect (23,Y constitution), or an X chromosome (23,X constitution). The development of such gonad into a testis depends upon the presence of the Y chromosome (59), whereas the absence of the Y chromosome will result in female development, irrespective of the number of X chromosomes (12,31,42). This effect was thought to be due to the presence of a unique gene located on the short arm of the Y chromosome (11).

Several years ago, such effect was supposed to be linked to a male-specific histocompatibility gene named the H-Y antigen (34), which was thought to be the primary testis-inducer (58). However it was soon found that such antigen did not explain all the sex-reversal cases observed in nature both in human and in mouse (47). Since then several genes have been proposed as candidates for the testis-determining factor (Fig. 1). An interval of 140 kb located between 140 and 280 kb of the proximal border of the pseudoautosomal pairing region was first isolated as the region with the testis-determining factor (TDF in the human and Tdf in the mouse) (35). Successive studies using recombinant DNA methods have tried to localize the TDF locus (Fig. 1). From a 140 KB region, a highly conserved gene was located in the 1A2 region of the Y chromosome, and named zinc finger protein-Y (ZFY), coding for zinc-finger-containing protein that could well function as a DNA-binding transcriptor regulator and be a good candidate for the testis-determining gene (28,36). However, an homologous sequence called zinc finger X (ZFX) was found on the X chromosome which questioned this hypothesis. From further deletion studies, it was found that the 1A1 region was the one most likely to contain the TDF gene. From this 60 kb region, a 35kb region was deducted, in which a single copy gene was found (48), that is highly conserved and shows homologies both with the sexual mating-type protein Mc required for mating in Schizosaccharides pombo yeast and with the nonhistone nuclear HMC (high mobility group) proteins expressed during embryogenesis (17,48); it was also thought to function as a DNA-binding transcription factor. This 14-kb gene has been named sex-determining region of the Y (SRY) in the human. The possibility remains that the ZFY and the SRY genes are two separate but neighbouring genes. However, testis development must only be possible through the interaction of Sry gene with other genes, located on autosomal chromosomes, some of which being involved in the regulation of Sry expression, others possibly being downstream targets of Sry (27).

Gonadal differentiation

The undifferentiated gonadal primordium, which is located at the ventral surface of the primitive kidney or mesonephros, is already visible in the 5 mm human embryo and consists of a thickening of the coelomic epithelium. In a first step, which is independent from the genetic sex, the gonadal primordium is colonized by the primordial germ cells originating from the allantoid sac. When these cells have reached the gonadal primordium, they form with the epithelium the " gonadal ridge ". The epithelium consists of two to three cylindric cells in which the gonocytes are present. This epithelium is separated from the mesonephros by a layer of mesenchymal cells. According to the classical Witschi’s theory, seminiferous tubules originate from the mesonephros, the " medulla ", while ovarian tissue originates from the secondary sex cords formed from the germinal epithelium or " cortex " (62). This theory is not universally accepted as recent observations have shown that the differentiation of the gonad occurs at same time of fetal age (7th week), for both the testis and the ovary (14).

Testicular differentiation

The differentiation of the gonadal ridge into a testis is a rapid phenomenon, which contrasts with the slow and late development of the ovary. Testicular tissues, and in particular seminiferous tubules, are recognized in the human embryo at 7 weeks of fetal age (crown-rump length 13-20 mm) (21). Inside the seminiferous tubules, germ cells are large. They divide actively but do not enter meiosis. Sertoli cells are smaller than the germ cells. They tend to surround the germ cells and prepare the future seminiferous tubules. A basal membrane is formed which isolates the tubules from the surrounding mesenchymal tissue. The individualization of tubules and the synthesis of the antimüllerian hormone precede Leydig cells differentiation (53). Leydig cells differentiate from interstitial tissue, between the 8th and the 9th week (crown-rump length 32-35 mm), and spread progressively in the intertubular spaces between the 14th and the 18th week. They secrete testosterone from the 8th week (61). Maximal fetal serum concentration is observed from the 14th to the 16th week. Levels are comparable to those observed in adult males. After 20 weeks of gestation, Leydig cells involute, and circulating testosterone levels decrease progressively to levels observed in female fetuses. At birth, cord blood testosterone levels are higher in male newborns than in females (13).

Fetal testes localized in the kidney region start to descent at the 12th week of fetal age, reaching the internal orifices of the inguinal canal at midgestation, and finally the scrotum during the last two months of gestation. The mechanical and humoral factors involved in this process are still unclear. It is presently accepted that the transabdominal descent is not androgen-dependent. It may be due to the intraabdominal pressure and/or the traction exerted by the gubernaculum testis, whose development would be linked to the presence of a low molecular weight factor, named " descendin ", not yet well identified, but distinct from polypeptide growth factors and fetal testicular hormones (10). The transinguinal part of the descent is thought to be mainly androgen-dependent (20).

Ovarian differentiation

Orientation of the primordial gonad towards ovarian differentiation in XX subjects appears after the 2nd month of fetal age. Intense proliferation of the germ cells under the coelomic epithelium forms clusters which move inside the gonad constituting the Pflüger’s cords or ovarian cortex. From the 9th week, germ cells enter into the meiotic prophase. At the 16th week, the first ovarian somatic cells appear between the ovarian cortex and the central zone. They form granulosa cells which encircle the oocytes, blocked at the diplotene stage of the first meiosis. They will remain at this stage till ovulation. These structures are the first ovarian follicles. They can further develop with antrum formation and luteinization (43).

The role of the sex chromosomes in the differentiation of the ovary remains hypothetical. Inactivation of one of the X chromosome in the somatic 46,XX cells occurs at a very early stage of embryogenesis. In the oocytes, both sex chromosomes remain functional (15). Whether the two X chromosomes are necessary for the ovarian differentiation is still debated. Normal meiosis in 45,X female fetuses has been described and the disappearance of the germ cells from these ovaries is a late phenomenon, occurring after the 12th week of fetal age (18,21,49). Death of the germ cell induces degeneration of the follicle and loss of the endocrine activity of the ovary which is replaced by fibrous tissue or streak formation.

In addition, the oocytes remain able to migrate from the cortical layers of the ovary to the surface epithelium of the ovary and to be extruded and liberated into the peritoneal cavity throughout all stages of fetal ovarian development. At the 5th month of fetal age human fetal ovary contains 7 millions germ cells. At 7 months the human fetal ovary does not form any additional germ cells. At birth, this number has fallen to 2 millions and, at 7 years of age, to 300,000 (1). The different development of oogonia, which are blocked at the diplotene stage, and spermatogonia, which enter into meiosis at puberty, has not been fully explained. The germ cells are stimulated by meiosis-inducing factors secreted by both the male and fetal gonad (4). This stimulating action is counteracted by inhibiting factors secreted by Sertoli cells or granulosa cells (26,33). Spermatogonia are very early caught in a tight network of Sertoli cells which blocks meiosis. Oogonia develop as long as they are not surrounded by the granulosa cells.

The fetal ovary is capable of synthesizing estradiol as early as the 8th week of fetal age (16). Whether this secretion of estradiol plays a physiologic role in the human sex differentiation is not known. However, low expressions of mRNA for both P-450scc and P-450c17 enzyme activities have been observed in fetal ovaries (57), in contradiction with the possible local secretion of estradiol.

Hormonal factors

Hormones secreted by the fetal differentiated gonads induce the development of the internal and external genitalia.

Fetal testis

Fetal Leydig cells produce testosterone in high amounts. There is circumstantial evidence that placental production of chorionic gonadotropin (hCG), which peaks at 12 weeks of fetal age, controls early fetal gonadal steroidogenesis (6). Testicular capacity of hCG binding is maximal at 15-20 weeks (32). Studies of the steroidogenic enzymes and of the expression of the steroidogenic enzyme genes have shown that cholesterol side-chain cleavage enzyme (P-450scc), adrenodoxin (iron-sulfur protein serving as an electron transport intermediate for P-450scc) and P-450c17 (17a-hydroxylase/17,20-lyase) genes are highly expressed in the fetal testis, mainly during the 14th and the 16th weeks. After 16 weeks, P-450c17 mRNA decreases more rapidly than P-450scc mRNA does (57). This age related pattern of P-450scc and P-450c17 mRNA is similar to fetal testicular and serum testosterone concentrations (44,45,52), and relates to the variations in hCG production and hCG receptors. These findings suggest that the expression of the steroidogenic genes is directly regulated by circulating hCG. The P-450Arom (aromatase gene) is poorly expressed in the fetal testis. The lack of significant local estradiol production may be an explanation for the non-desensitization of the fetal Leydig cells in the presence of high levels of hCG (29).

Fetal Sertoli cells produce the antimüllerian hormone (AMH, also named müllerian-inhibiting substance, or müllerian-inhibiting hormone). The existence of the antimüllerian hormone was postulated by Jost in 1947 (25). It is a glycoprotein of 145 kD molecular weight (40) which is secreted by the immature Sertoli cells, from early differentiation till puberty (7,22). Testicular production of AMH is maximal during the period of müllerian duct regression in males and decreases to a plateau throughout gestation (3,22). The role of AMH in later male development is not known, but an inhibitory effect on male germ-cell meiosis in fetal life, and a positive effect on testicular descent have been suggested (23). Human gene for AMH, which is located on chromosome 19, has been cloned and sequenced (5,41). AMH mRNA is readily detectable in human fetal testis with no significant change from 13 to 25 weeks of gestation (57). Proteolytic cleavage of AMH induces TGF-ß-like fragment. AMH has extramüllerian effects, such as an inhibiting action on the development of ovarian and uterine tumoral cells (8,23) and a virilizing action on fetal rat ovary, inducing structures similar to seminiferous tubules and secretion of testosterone instead of estradiol (55). The latter shift in steroidogenesis results from a repressor action of AMH on the biosynthesis of aromatase (56). This rises the possible role of AMH on the differentiation of the fetal testis as initiated by the SRY gene. In addition, AMH inhibits maturation of fetal lung cells, by its anti-EGF action. Persistent müllerian duct syndrome can be due to absence of AMH or to absent AMH receptors on target tissues.

Insulin-like growth factor I (IGF-I) concentration is weak in fetal testis (57). Conversely, insulin-like growth factor II (IGF-II) is abundant. IGF-II mRNA is present in large quantities. The developmental pattern of IGF-II mRNA expression is similar to that of the steroidogenic enzymes P-450scc and P-450c17: highest expression at 14-16 weeks and decrease thereafter (57). This pattern of IGF-II gene expression is not regulated in a similar way as that of the steroidogenic enzyme genes and could be only age-dependent.

Fetal ovary

Fetal ovary is able to convert androgens to estrogens in vitro (16). The physiological significance of the presence of aromatase in the fetal ovary remains unexplained, as the fetal ovary is lacking the other steroidogenic enzymes necessary for the synthesis of the steroid precursors (39). Aromatase mRNA is found at a weak level in the fetal ovary, fitting, however, with the observed fetal ovarian aromatase activity. In addition, during early gestation the fetal ovary does not contain hCG receptors (32) and its further development during late gestation may be dependent on the presence of pituitary gonadotropins (45). Gene expression of P-450scc, P-450c17 enzymes is very low in the fetal ovary (57). Fetal ovarian adrenodoxin mRNA abundance is about 50% of that of the testis (57). The significance of this relatively high adrenodoxin gene expression in a steroidogenically inactive fetal gonad remains unknown. AMH is not detectable in the fetal ovary. Only very small amounts of AMH mRNA can be detected in fetal ovarian tissue contrary to the adult ovary granulosa cells where AMH mRNA can be clearly detected (57). IGF-II mRNA can be also detected in the fetal ovary as well as in the fetal testis.

Differentiation of the internal and the external genitalia

The internal genitalia derives from the differentiation of two pairs of ducts: the wolffian ducts and the müllerian ducts (Fig. 2). Both ducts develop from the part of the mesonephros which does not participate to the formation of the fetal gonad. They both end in the urogenital sinus which opens to the perineum at the level of the urogenital orifice, located at the base of the genital tubercle.

Wolffian ducts

Wolffian ducts are present in the embryo at a crown-rump length of 4-5 mm, and serve as the excreting duct to the mesonephros. When the definitive kidney becomes functional, the wolffian duct that is dependent of the presence of androgens becomes the vas deferens system. In the female fetus, the wolffian ducts degenerate. In the male fetus, the anterior part of the wolffian ducts communicate with the seminiferous tubules, the posterior part forms the vas deferens and the seminal vesicle. This differentiation is dependent of high local concentration of testosterone, which is only active during a " critical " period during which the wolffian duct is sensitive. Testosterone and not dihydrotestosterone, is the active hormone as the wolffian duct does not contain 5a-reductase activity at this stage of development (46). Testosterone receptors are present and their number increase with age. Development of the wolffian ducts can be partially inhibited by the injection of testosterone antibodies, or administration of cyproterone acetate to the pregnant animal (2,9). In male pseudohermaphroditism, the maintenance and differentiation of the wolffian ducts can be observed, because some testosterone is secreted very early and at low concentration, suggesting that their complete development is dependent of very high local concentration of testosterone.

Müllerian ducts

Müllerian ducts appear in the human embryo at crown-rump length 10 mm. When the embryo is 50 mm, the uterovaginal canal formed by the reunion of both caudal terminals joins the posterior wall of the urogenital sinus, between the two orifices of the wolffian ducts. In the female embryo, müllerian ducts differentiate into fallopian tubes, the uterus and the upper part of the vagina. The uterine cervix develops later at crown-rump length 150mm. Receptors for estradiol have been found in the müllerian ducts (38,51), but their physiological significance is unknown as estrogens are not necessary for the differentiation of the female internal genitalia. In the male fetus, müllerian ducts begin to regress at crown-rump length 30 mm and have disappeared at crown-rump length 43 mm. This regression is due to the presence of the antimüllerian hormone (AMH). The müllerian duct is sensitive to AMH during a limited period of fetal development (up to 8 weeks in the human fetus). This hormone only acts locally.

Gonadectomy performed in male rabbit fetuses before the age of differentiation induces the degeneration of the wolffian ducts and the development of the müllerian ducts into fallopian tubes, uterus and the upper part of the vagina (24). In opposite experiments with female fetuses, locally implanted fetal testis induce the regression of the müllerian ducts and the development of the wolffian ducts. Local implants of testosterone induce development of the wolffian ducts and no regression of the müllerian ducts. These experiments led Jost to develop the concept of the two hormones: AMH and testosterone, influencing the differentiation of the male fetus (25).

Differentiation of the urogenital sinus and the external genitalia

In both sexes the urogenital and the external genitalia are similar up to the 9th week (crown-rump length 30 mm). The müllerian tubercle protrudes from the posterior wall of the urogenital sinus, between the two orifices of the wolffian ducts (Fig. 3). The external genitalia differentiate from the genital tubercle and the two lateral urethral folds and labioscrotal swellings (Fig. 4).

In the female fetus, vaginal organogenesis consists of the development of a vaginal plaque from the müllerian tubercle separating the müllerian vagina and the urogenital sinus. Later this vaginal plaque forms a canal (at crown-rump length 200 mm) and its upper part opens to the uterine cervix, while the müllerian vaginal epithelium regresses. Administration of high doses of estrogens to pregnant women prevents the progression of the vaginal epithelium from sinus origin. The persisting müllerian epithelium would be responsible for the vaginal adenosis frequently observed in girls who were submitted to high doses of estrogens in utero (54). The genital tubercle becomes the clitoris, the labioscrotal swellings do not fuse and the perineal anogenital distance does not increase.

In the male fetus, masculinization of the external genitalia begins at crown-rump length 43-45 mm. The vaginal plaque, which is small, forms the prostatic utricule. The urogenital sinus increases in length and forms the prostatic and the perineal urethra. The genital labioscrotal swellings fuse and the anogenital distance increases. At crown-rump length 90 mm (12th-14 weeks) the penile urethra is formed. The growth of the genital tubercle continues during gestation. The differentiation of the urogenital sinus and the external genitalia depends on the presence of the fetal testicle. In its absence, whether ovaries are present or not, the vagina develops and the labioscrotal swellings do not fuse. Testosterone is the hormone responsible for the male differentiation of the urogenital sinus and the external genitalia. However the presence of the 5a-reductase is necessary as the active metabolite on the external genitalia is dihydrotestosterone (46,60). The enzyme has been detected in these organs prior to their masculinization. Testosterone acts directly on the differentiation of the epididymis, the vas deferens and the seminal vesicle. Reduction of testosterone to dihydrotestosterone by 5a-reductase is necessary to obtain differentiation of the prostate, the prostatic utricule, the scrotum and the penis (Fig. 5). High dose of estrogens administrated in the pregnant animal may cause abnormal development of the male genitalia, leading to an intersex condition. Such anomalies have been described in human male neonates whose mothers have received diethylstilbestrol during pregnancy (19).

Conclusions

The concept proposed by Jost of an asymmetrical sex differentiation remains nowadays valid. It consists of a developmental pattern in which the " passive " female differentiation is counteracted by male genetic and hormonal factors, the sex-determining gene(s), and the two male hormones, testosterone and antimüllerian hormone. These factors and hormones act on target cells and tissues only during a " critical " period of development. The mechanism of this chronological " critical " period still lacks to date an adequate biological explanation.

Aging and Sex

Sex and aging has become an issue of growing popularity. At the same time, with changing dietary and activity patterns, and new medical treatments, many people in their senior years are relatively healthy and desirous of continuing an active life, including an active sex life. While prior to the 1960s the topic of sex in later life was consciously ignored in the media, not included in most sex research, and considered an inappropriate issue for public discussion, today it is receiving increasing attention.

Indeed, the first serious book on the topic was not published until the 1960s, and the first reliable study did not appear until 1966 with the publication of the seminal work of sex researchers Masters and Johnson.

Even now the topic of sexuality and aging is often treated with tremendous sentimentality or with derisive humor, and it is hard for some people to conceive of sexual desire and passion among the elderly except in terms of lechery. While perhaps receding in the popular imagination, the image of the "dirty old man" that chases after young women has not disappeared.

Moreover, until recently, feelings of sexuality and sexual need among those over 60 years of age might be cause for guilt feelings, based on the culturally constructed assumption that people were supposed to "mature out of" sexual interest and become sexual neuters as they entered into their so-called "golden years."

New studies, like "The Starr-Weiner Report on Sex and Sexuality in the Mature Years" (1981) and "E. Brecher's Love, Sex, and Aging" (1984) have provided new information about sexual behavior and attitudes among those over 60 years of age. The understanding of normal sexual needs and practices among the elderly that emerges from this research contradicts earlier assumptions and stereotypes.

Aging Doesn't Diminish Sex Drive
Generally, this research has found that age typically does not significantly diminish the need and desire for sex, that regular sexual activity is standard when a partner is available, and that most elderly believe that sex contributes to both physical and psychological health.

Furthermore, studies have shown that physical capacity for male erection and male and female orgasm continue almost indefinitely, and that achieving orgasm is desired but not always achieved. Research has also found that sexual practices are varied and include masturbation and oral sex, in addition to intercourse, and, for many, sexual satisfaction increases rather than decreases as individuals enter into their senior years.
In terms of problems, impotence and failure to achieve orgasm as well as failure to find suitable partners are important sources of frustration. These studies have led to the realization — now generally accepted among psychologists and sex therapists—that sexual interest and the need for sexual contact continue throughout the life cycle, although patterns differ somewhat for women and men.

Differences in sexual patterns between males and females are found throughout the life cycle. While capacity for erection in males begins while they are still in the womb, reproductive ability (i.e., the production of semen) begins at about age 13, but may not start until the boy is 16 years of age. As this suggests, there is considerable normal variation among males, as well as females, in the onset of various changes in sexuality.

When Boys Reach Sexual Peak
Boys reach the height of their sexual functioning at about age 18, followed by a slow drop in their capacity for erection and ejaculation from that point on. The drop in male steroid hormones only becomes measurable by about age 30. With declining hormonal production, there is a slow decline in the speed of physiological responsiveness and a lengthening of the refractory period — the time needed after ejaculation for the penis to again be able to achieve an erection.

By age 40, most men begin to experience a decrease in physiological responsiveness, sexual arousability and functioning. There continues to be a gradual decline through the 50's. Although there is wide variability, at this point males generally are only half as sexually active as they were at the peak of their capacity in their late teens and early twenties.

During the late 40s and increasing gradually thereafter, the urgency of sexual interest declines, erection is less frequent and more difficult to sustain, the turgidity of the erection diminishes, ejaculation is less forceful, and refractory time is lengthened.

After age 40, many men begin to experience periodic inability to achieve an erection and the frequency of this incapacity increases over time and becomes quite common by the 60s. However, although by the 60s all of the changes noted above are quite noticeable in almost all men, the pleasure they derive from sex may not be significantly affected.
Indeed, recent studies show that most men (unless they have certain health problems) are able to participate in and enjoy sex their entire life span, and many are able to produce viable semen until quite late in life (Pablo Picasso reportedly fathered a child at 90 years of age). Thus it is not completely surprising to discover that, in recent years, elderly men in senior housing apartments have become a regular source of clients among prostitutes.

Various factors can limit sexual interest and capacity in men as they age. There are a number of organic problems of the heart and circulatory system, glands and hormonal system, and the nervous system that can, to varying degrees, diminish male capacity for and interest in sex. And the side effects of many medications used to treat some of these organic conditions can themselves compound the problem.

Masters and Johnson originally reported that as much as 90 percent of male impotence has a psychological origin. Due to more sophisticated urological testing procedures it is now estimated that only about 40 percent of erectile problems are purely psychological.

Aging and Sex on Male Impotence
The majority of causes of male impotence have their origin in hormonal, vascular or neurological factors. Regardless of the causes of erectile difficulty, there is always a psychological effect on the male. Men who experience an inability to achieve or sustain an erection on several occasions may be so anxious about inadequacy that a self-defeating process is initiated that causes them to avoid sexual situations and sexual arousal.

Other psychological factors, including depression, lowered self-esteem associated with overall loss of physical strength and the onset of physical signs of aging, anxiety, and substance abuse can all contribute to male impotence.

Sexual Response in Women
The capacity for sexual reproduction begins earlier in females than in males, often two years earlier. However, the commencement of puberty varies among girls and may not begin until age 14 or 15. Women differ from men in that the decline in sexual responsiveness with aging is quite gradual.
Indeed, recent studies show that most men (unless they have certain health problems) are able to participate in and enjoy sex their entire life span, and many are able to produce viable semen until quite late in life (Pablo Picasso reportedly fathered a child at 90 years of age). Thus it is not completely surprising to discover that, in recent years, elderly men in senior housing apartments have become a regular source of clients among prostitutes.

Various factors can limit sexual interest and capacity in men as they age. There are a number of organic problems of the heart and circulatory system, glands and hormonal system, and the nervous system that can, to varying degrees, diminish male capacity for and interest in sex. And the side effects of many medications used to treat some of these organic conditions can themselves compound the problem.

Masters and Johnson originally reported that as much as 90 percent of male impotence has a psychological origin. Due to more sophisticated urological testing procedures it is now estimated that only about 40 percent of erectile problems are purely psychological.

Aging and Sex on Male Impotence
The majority of causes of male impotence have their origin in hormonal, vascular or neurological factors. Regardless of the causes of erectile difficulty, there is always a psychological effect on the male. Men who experience an inability to achieve or sustain an erection on several occasions may be so anxious about inadequacy that a self-defeating process is initiated that causes them to avoid sexual situations and sexual arousal.

Other psychological factors, including depression, lowered self-esteem associated with overall loss of physical strength and the onset of physical signs of aging, anxiety, and substance abuse can all contribute to male impotence.

Sexual Response in Women
The capacity for sexual reproduction begins earlier in females than in males, often two years earlier. However, the commencement of puberty varies among girls and may not begin until age 14 or 15. Women differ from men in that the decline in sexual responsiveness with aging is quite gradual.